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The Interrelation Between Chronic Headache, Cognitive Scores, and MRI Markers Among Stroke Survivors
Jeremy Molad1, Hen Hallevi1,2, Amos D Korczyn2
1Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
Background:
Migraine is known to mildly increase the risk for ischemic stroke and is associated with vascular MRI markers. However, the potential effect of chronic headache (CH) on stroke outcomes has not been studied.
Objective:
We aimed to assess the interrelation between CH and post-stroke cognitive impairment.
Methods:
Data from 455 patients with a first ever stroke from the TABASCO study was available. All patients underwent 3T brain MRI, blood analysis, and a serial cognitive assessment at baseline and 6, 12, and 24 months after.
Results:
Eighty-five (18.7%) patients reported suffering from CH, of whom 53 (62.4%) reported symptoms of photophobia or nausea, and 34 (40%) reported an aura. CH was associated with female sex, lower prevalence of T2DM (p < 0.001), and lower HbA1C levels (p < 0.001). Multiple regression analysis, controlling for age, sex, education, vascular risk factors, and the presence of acute lesions in MRI, revealed that CH was an independent predictor of better cognitive scores 6, 12, and 24 months post-stroke (p = 0.015, p = 0.01, and p = 0.012, respectively). Stroke patients suffering from CH had also higher normalized gray, white matter, and thalamus volumes, and better white matter microstructural integrity (p < 0.001, p = 0.037, p < 0.001, p = 0.008, respectively)Conclusion:In this study, CH was consistently associated with better long term cognitive scores among post stroke subjects. These surprising findings may partially arise from the higher prevalence of T2DM among subjects without CH, that may represent the existence of chronic cerebrovascular disease, and may reflect mechanisms involving glucose metabolism.
Insights
Chronic headache (CH) in stroke patients was linked to better long-term cognitive function and brain health. This study suggests CH may be associated with improved stroke outcomes, potentially due to differences in diabetes prevalence.
Area of Science:
- Neurology
- Neuroscience
- Stroke Research
Background:
- Migraine is a known risk factor for ischemic stroke.
- Vascular magnetic resonance imaging (MRI) markers are associated with migraine.
- The impact of chronic headache (CH) on stroke outcomes remains unstudied.
Purpose of the Study:
- To investigate the relationship between chronic headache (CH) and cognitive impairment after stroke.
- To assess if CH influences long-term cognitive function in stroke survivors.
Main Methods:
- Utilized data from 455 first-ever stroke patients from the TABASCO study.
- Performed 3T brain MRI, blood analysis, and serial cognitive assessments up to 24 months post-stroke.
- Employed multiple regression analysis controlling for demographic and vascular risk factors.
Main Results:
- 18.7% of stroke patients reported chronic headache (CH).
- CH was an independent predictor of better cognitive scores at 6, 12, and 24 months post-stroke.
- CH patients exhibited higher brain volumes (gray matter, white matter, thalamus) and better white matter integrity.
Conclusions:
- Chronic headache (CH) is associated with better long-term cognitive outcomes in post-stroke individuals.
- Findings may be partly explained by a lower prevalence of type 2 diabetes mellitus (T2DM) in CH patients, suggesting potential links to cerebrovascular disease and glucose metabolism.
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